Cervical cryotherapy
Definition
Cervical cryotherapy is a procedure which involves freezing an area of abnormal tissue on the cervix. This tissue gradually disappears and the cervix heals. One cervical cryotherapy is usually sufficient to destroy the abnormal tissue.
Purpose
Cervical cryotherapy is a standard method used to treat cervical dysplasia, meaning the removal of abnormal cell tissue on the cervix.
Description
Cervical cryotherapy, or freezing, usually lasts about five minutes and causes a slight amount of discomfort. The procedure is usually performed in an outpatient setting.
Cervical cryotherapy is done by placing a small freeze-probe (cryoprobe) against the cervix that cools the cervix to sub-zero temperatures. The cells destroyed by freezing are shed afterwards in a heavy watery discharge. The main advantage of cryotherapy is that it is a simple procedure that requires inexpensive equipment.
The cryogenic device consists of a gas tank containing a refrigerant and non-explosive, non-toxic gas (usually nitrous oxide). The gas is delivered using flexible tubing through a gun-type attachment to the cryoprobe.
Diagnosis/Preparation
Women who undergo cervical cryotherapy typically have had an abnormal Pap smear which has led to a diagnosis of cervical squamous dysplasia and usually confirmed by biopsy after an adequate colposcopic exam.
Preparation for cervical cryotherapy involves scheduling the procedure when the patient is not experiencing heavy menstrual flow. Ibuprofen, ketoprofen, or naproxen sodium may be given before cryotherapy to decrease cramping. If there is any doubt about the pregnancy status, a pregnancy test is performed.
Aftercare
Cervical cryotherapy is often followed by a heavy and often odorous discharge during the first month after the procedure. The discharge is due to the dead tissue cells leaving the treatment site, and Aminocerv cream may be prescribed. The patient should abstain from sexual intercourse and not use tampons for a period of three weeks after the procedure. Excessive exercise should also be avoided to lessen the occurrence of post-therapy bleeding.
Risks
The following risks have been associated with cervical cryotherapy:
- Uterine cramping. Often occurs during the cryotherapy but rapidly subsides after treatment.
- Bleeding and infection. Rare, but incidences have been reported.
- More difficult Pap smears. Future Pap smears and colposcopy may be more difficult after cryotherapy.
Normal results
A normal result is no recurrence of the abnormal cervix cells. The first follow-up Pap smear is done within three to six months. If normal, Pap smears are repeated every six months for two years. If any, recurrences usually occur within two years of treatment. Another option is to replace the initial and each yearly Pap smear with a colposcopic examination.
If a follow-up Pap smear is abnormal, a colposcopy with biopsy is usually performed. Other treatment methods, usually the loop electrocautery excision procedure (LEEP) are then used if persistent disease is discovered.
Following the procedure, it is considered normal to experience the following:
- slight cramping for two to three days
- watery discharge requiring several pad changes daily
- bloody discharge, especially 12–16 days after the procedure
Alternatives
Alternatives to cryotherapy include:
- Laser treatment. A carbon dioxide laser focuses a beam of light to vaporize the abnormal cells. This technique can be used in the physician's office with very little discomfort.
- Loop electrocautery excision procedure (LEEP). This procedure uses a fine wire loop with an electric current flowing through it to remove the desired area of the cervix. Loop excision is usually done under local anesthesia and causes very little discomfort.
See also Colposcopy ; Cone biopsy ; Cryotherapy .
Resources
BOOKS
Handley, J. What Your Doctor May Not Tell You about HPV and Abnormal Pap Smears. New York: Warner Books, 2002.
Platzer, W., et al. Vaginal Operations: Surgical Anatomy and Technique. Philadelphia: Lippincott, Williams and Wilikins, 1996.
Rushing, L., and N. Joste. Abnormal Pap Smears: What Every Woman Needs to Know. Amherst, NY: Prometheus Books, 2001.
PERIODICALS
Sparks, R. A., D. Scheid, V. Loemker, E. Stader, K. Reilly, R. Hamm, and L. McCarthy. "Association of Cervical Cryotherapy with Inadequate Follow-up Colposcopy." Journal of Family Practice 51 (June 2002): 526–529.
Tate, D. R. and R. J. Anderson. "Recrudescence of Cervical Dysplasia among Women Who are Infected with the Human Immunodeficiency Virus: A Case-control Analysis." American Journal of Obstetrics and Gynecology 186 (May 2002): 880–882.
ORGANIZATIONS
American Society for Colposcopy and Cervical Pathology. 20 West Washington St., Suite 1, Hagerstown, MD 21740. (301) 733-3640. http://www.asccp.org/index.html
National Association for Women's Health. 300 W. Adams Street, Suite 328, Chicago, IL 60606-5101. (312) 786-1468. http://www.nawh.org
OTHER
"Cervical Cancer Prevention." JHPIEG. September 2002 [cited April 2003]. http://www.jhpiego.jhu.edu/cecap .
"Cytopathology." The Internet Pathology Laboratory for Medical Education [cited April 2003].
Mayeaux Jr., E. J., M.D. "Cervical Cryotherapy Atlas." LSUH SC-S Family Medicine Server [cited April 2003]. http://lib-sh.lsumc.edu/fammed/atlases/cryo.html .
National Women's Health Information Center [cited April 2003]. http://www.4woman.org .
"What is cervical dysplasia?" AMA Medical Library [cited April 2003]. http://www.medem.com .
Monique Laberge, Ph. D.
WHO PERFORMS THE PROCEDURE AND WHERE IS IT PERFORMED?
Cervical cryotherapy can be done in the treating physician's office. The physician is usually a gynecologist.
QUESTIONS TO ASK THE DOCTOR
- How is cervical cryotherapy performed?
- Why is cryotherapy required?
- What are the risks of cryotherapy?
- Is cryotherapy painful?
- What is the purpose of my cryotherapy?
- How long will it take to recover from the surgery?
- What are the after-effects of cryotherapy?
- How much cervical cryotherapy do you perform each year?
Very relieving
Best regards
Thanks!
Just curious if anyone else has felt this way afterwards
Just curious if anyone else has felt this way afterwards
my wife had a problem. doctors suggest for Cryotherpy, suggest what to do ?
I went In just for a well womans exam. Got a call that my paps came back abnormal and I needed to go back to the doctors office. There he explained that it showed I had abnormal cells. He wanted to do a colposcopy and if he saw anything that he would have to do a biopsy. He ended up cutting 6 pieces to send for a biopsy. It hurt so bad!!! No anesthetic used :/ the girls said it would take about a week to get the results. ( took 2 weeks) I finally called them and they said the results came back positive and he wanted to do cryosurgery right away. I have the highest level of abnormal cells. The doctor said it wouldn't be to bad and nothing compared to the biopsy.I had my procedure done 3 days ago. I guess everyone is different because for those 2 minutes it felt like eternity. Cramps almost felt as bad as contractions afterwards. He wants to see me back in 3 months and get tested again. I still have the watery discharge and the foul odor seems to be going away. Yesterday I felt fine but today I was getting really bad cramps and my back has been killing me. I hope he got all the bad cells, I dont want to repeat this procedure ever again...
Is this normal?
Does anyone have similiar symptoms? oh sex is painful just if it is too rough or up against my cervix.